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General NPI Number Information
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NPI Number | 1073991543
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Entity Type | Organization
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Legal Business Name | EVERCLEAR HEARING PRODUCTS
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Dates
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Enumeration Date | 05/15/2015
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Last Update Date | 08/24/2021
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Provider Practice Location Address
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Address Line | 2215 E CLAIREMONT AVE SUITE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4772
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Country | US
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Telephone | 715-831-0289
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Fax | 715-831-4722
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Provider Business Mailing Address
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Address Line | 2215 E CLAIREMONT AVE SUITE 2
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4772
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Country | US
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Telephone | 715-831-0289
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Fax | 715-831-4722
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | PATRICE DIANE ROGSTAD
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Credential | H.I.S.
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Telephone | 715-831-0289
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 30-156
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 1285-60
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License Number State | WI
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